- Cardiology and Cardiovascular Medicine
- Complete or incomplete revascularization in patients with left main culprit lesion acute myocardial infarction with multivessel disease: a retrospective observational study
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Sun Oh Kim
, Hong-Ju Kim , Jong-Il Park , Kang-Un Choi , Jong-Ho Nam , Chan-Hee Lee , Jang-Won Son , Jong-Seon Park , Sung-Ho Her , Ki-Yuk Chang , Tae-Hoon Ahn , Myung-Ho Jeong , Seung-Woon Rha , Hyo-Soo Kim , Hyeon-Cheol Gwon , In-Whan Seong , Kyung-Kuk Hwang , Seung-Ho Hur , Kwang-Soo Cha , Seok-Kyu Oh , Jei-Keon Chae , Ung Kim
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J Yeungnam Med Sci. 2025;42:18. Published online December 19, 2024
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DOI: https://doi.org/10.12701/jyms.2025.42.18
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Abstract
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- Background
Complete revascularization has demonstrated better outcomes in patients with acute myocardial infarction (AMI) and multivessel disease. However, in the case of left main (LM) culprit lesion AMI with multivessel disease, there is limited evidence to suggest that complete revascularization is better.
Methods We reviewed 16,831 patients in the Korea Acute Myocardial Infarction Registry who were treated from July 2016 to June 2020, and 399 patients were enrolled with LM culprit lesion AMI treated with percutaneous coronary intervention. We categorized the patients as those treated with complete revascularization (n=295) or incomplete revascularization (n=104). The study endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, myocardial infarction, ischemia-driven revascularization, stent thrombosis, and stroke. We performed propensity score matching (PSM) and analyzed the incidence of MACCE at 1 year.
Results After PSM, the two groups were well balanced. There was no significant difference between the two groups in MACCE at 1 year (12.1% vs. 15.2%; hazard ratio, 1.28; 95% confidence interval, 0.60–2.74; p=0.524) after PSM. The components of MACCE and major bleeding were also not significantly different.
Conclusion There was no significant difference in clinical outcomes between the groups treated with complete or incomplete revascularization for LM culprit lesion AMI with multivessel disease.
- Cardiology and Cardiovascular Medicine
- Acute left main coronary artery thrombosis as an initial presentation of systemic lupus erythematosus
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Kang Un Choi
, Ung Kim
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Yeungnam Univ J Med. 2018;35(2):227-231. Published online December 31, 2018
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DOI: https://doi.org/10.12701/yujm.2018.35.2.227
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Abstract
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- Left main coronary artery (LMCA) thrombosis is rare and the cause should be determined. A previously healthy young man presented with severe chest pain and dyspnea. The electrocardiogram showed typical ST-segment elevation myocardial infarction with clinical instability. Emergency coronary angiography revealed complete LMCA occlusion by thrombosis. After reperfusion, the patient was admitted to the cardiac care unit. He was diagnosed with hemolytic anemia and tested positive for antinuclear antibodies. Systemic lupus erythematosus (SLE) and LMCA disease due to systemic thrombosis were diagnosed. Steroids were started and the patient was discharged without complications. We report this rare case of LMCA thrombosis as an initial presentation of SLE.
- Cardiology and Cardiovascular Medicine
- Recent updates in transcatheter aortic valve implantation
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Jeonghwan Cho
, Ung Kim
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Yeungnam Univ J Med. 2018;35(1):17-26. Published online June 30, 2018
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DOI: https://doi.org/10.12701/yujm.2018.35.1.17
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Abstract
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- Transcatheter aortic valve implantation (TAVI) has evolved from a challenging intervention to a standardized, simple, and streamlined procedure with over 350,000 procedures performed in over 70 countries. It is now a novel alternative to surgical aortic valve replacement in patients with intermediate surgical risk and its indications have been expanded to cohorts with bicuspid aortic valves, low surgical risk, and younger age and fewer comorbidities. Attention should be paid to further reducing remaining complications, such as paravalvular aortic regurgitation, conduction abnormalities, cardiac tamponade, and stroke. The aim of this review is to provide an overview on the rapidly changing field of TAVI treatment and to explore past achievements, current issues, and future perspectives of this treatment modality.
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Citations
Citations to this article as recorded by 
- Surgical Repair of Ventricular Septal Defect Following Transcatheter Aortic Valve Implantation: A Case Report
Satoru Fujii, Mohammed Tarabzoni, Pantelis Diamantouros, Rodrigo Bagur, Michael W. A. Chu A&A Practice.2024; 18(6): e01790. CrossRef - Might simplification of transcatheter aortic valve implantation reduce the burden on hospital resources?
Lenka Kratochvílová, Petr Mašek, Marek Neuberg, Markéta Nováčková, Petr Toušek, Jakub Sulženko, Tomáš Buděšínský, , and Viktor Kočka European Heart Journal Supplements.2022; 24(Supplement): B28. CrossRef
- Cardiology and Cardiovascular Medicine
- The Difference of Left Atrial Volume Index: Can It Predict the Occurrence of Atrial Fibrillation after Radiofrequency Ablation of Atrial Flutter?.
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Ung Kim, Young Jo Kim, Sang Wook Kang, In Wook Song, Jung Hwan Jo, Sang Hee Lee, Geu Ru Hong, Jong Seon Park, Dong Gu Shin
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Yeungnam Univ J Med. 2007;24(2):197-205. Published online December 31, 2007
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DOI: https://doi.org/10.12701/yujm.2007.24.2.197
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Abstract
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- BACKGROUND
The occurrence of atrial fibrillation after ablation of atrial flutter is clinically important. We investigated variables predicting this evolution in ablated patients without a previous atrial fibrillation history. MATERIALS AND METHODS: Thirty-six patients (Male=28) who were diagnosed as atrial flutter without previous atrial fibrillation history were enrolled in this study. Group 1 (n=11) was defined as those who developed atrial fibrillation after atrial flutter ablation during 1 year follow-up. Group 2 (n=25) was defined as those who has not occurred atrial fibrillation during same follow-up term. Echocardiogram was performed to all patients. We measured left atrial size, left ventricle end diastolic and systolic dimension, ejection fraction and left atrial volume index before and after ablation of atrial flutter. The differences of each variables were compared and analyzed between two groups. RESULTS: The preablation left ventricular ejection fraction (preLVEF) and postablation left ventricular ejection fraction (postLVEF) are 54+/-14%, 56+/-13% in group 1 and 47+/-16%, 52+/-13% in group 2. The differences between each two groups are statistically insignificant (2.2+/-1.5 in group 1 vs 5.4+/-9.8 in group 2, p=0.53). The preablation left atrial size (preLA) and postablation left atrial size (postLA) are 40+/-4 mm, 41+/-4 mm in group1 and 44+/-8 mm, 41+/-4 mm in group 2. The atrial sizes of both groups were increased but, the differences of left atrial size between two groups before and after flutter ablation were statistically insignificant (0.6+/-0.9mm in group 1 vs -3.8+/-7.4 mm in group 2, p=0.149). The left atrial volume index before flutter ablation was significantly reduced in group 1 than group 2 (32+/-10 mm3/m2, 35+/-10 mm3/m2 in group 1 and 32+/-10 mm3/m2, 29+/-8 mm3/m2 in group 2, p<0.05). CONCLUSION: The difference between left atrial volume index before and after atrial flutter ablation is the robust predictor of occurrence of atrial fibrillation after atrial flutter ablation without previous atrial fibrillation.
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